Analysis of SARS-CoV-2 genome evolutionary patterns.

The spread of SARS-CoV-2 virus accompanied by public availability of abundant sequence data provides a window for the determination of viral evolutionary patterns. In this study, SARS-CoV-2 genome sequences were collected from seven countries in the period January 2020-December 2022. The sequences were classified into three phases, namely, pre-vaccination, post-vaccination, and recent period. Comparison was performed between these phases based on parameters like mutation rates, selection pressure (dN/dS ratio), and transition to transversion ratios (Ti/Tv). Similar comparisons were performed among SARS-CoV-2 variants. Statistical significance was tested using Graphpad unpaired t-test. The analysis showed an increase in the percent genomic mutation rates post-vaccination and in recent periods across all countries from the pre-vaccination sequences. Mutation rates were highest in NSP3, S, N, and NSP12b before and increased further after vaccination. NSP4 showed the largest change in mutation rates after vaccination. The dN/dS ratios showed purifying selection that shifted toward neutral selection after vaccination. N, ORF8, ORF3a, and ORF10 were under highest positive selection before vaccination. Shift toward neutral selection was driven by E, NSP3, and ORF7a in the after vaccination set. In recent sequences, the largest dN/dS change was observed in E, NSP1, and NSP13. The Ti/Tv ratios decreased with time. C→U and G→U were the most frequent transitions and transversions. However, U→G was the most frequent transversion in recent period. The Omicron variant had the highest genomic mutation rates, while Delta showed the highest dN/dS ratio. Protein-wise dN/dS ratio was also seen to vary across the different variants.IMPORTANCETo the best of our knowledge, there exists no other large-scale study of the genomic and protein-wise mutation patterns during the time course of evolution in different countries. Analyzing the SARS-CoV-2 evolutionary patterns in view of the varying spatial, temporal, and biological signals is important for diagnostics, therapeutics, and pharmacovigilance of SARS-CoV-2.

Severe laryngeal injuries masked by fractured mandible.

UNLABELLED: A 17-year-old male was referred to the maxillofacial department regarding a fractured mandible. Airway compromise was suspected as a result of neck swelling, stridor, haemoptysis and surgical emphysema. Severe laryngeal injuries were diagnosed, including a fractured hyoid. His treatment and outcomes are summarized, with discussion of aetiology, symptoms, diagnosis and treatment of laryngeal injuries, including urgent airway management, if necessary. The risks and complications of delayed diagnosis and treatment are discussed, particularly if symptoms are delayed or the injury is masked by facial fractures. A high index of suspicion and thorough examination are emphasized in all head and neck trauma patients. CLINICAL RELEVANCE: Any dental professional may be the first to see a trauma victim. It is important to be aware of the risk of life-threatening laryngeal injuries which may be delayed in diagnosis, owing to later development of symptoms and signs or to more obvious injuries.

Immunomodulatory effects of probiotics and prilled fat supplementation on immune genes expression and lymphocyte proliferation of transition stage Karan Fries cows.

BACKGROUND AND AIM: Probiotics are the living microorganism which when administered improves the digestion and health of the animal. Saccharomyces cerevisiae (SC) improves the humoral and innate immunity of the animal. Prilled fat is a hydrogenated palm oil triglyceride which has been reported to promote the release of cytokines from macrophages. The aim of the study was to evaluate the immunomodulatory effect of probiotic and prilled fat during transition stage in Karan Fries (KF) cows. MATERIALS AND METHODS: A total of 12 KF cows at 21 days prepartum were selected and divided into two groups of six animals each. The control group was fed as per the standard feeding practices and the supplemented group cows were supplemented daily with prilled fat at 100 g/cow, SC at 25 g/cow, and sweetener at 1 g/cow in addition to the standard feeding practices from -30 days of prepartum to 21 days of lactation. The sweetener was added to improve the palatability of the feed. The natural sweetener of an African plant leave had 105 times more sweetness than glucose with good aroma. The dry matter intake of the animal was recorded. Plasma samples were collected weekly from all cows for the analysis of blood metabolite beta-hydroxybutyric acid (BHBA). Lymphocytes were isolated from the blood for studying the expression of tumor necrosis factor alpha (TNF-α) and interleukin-1ß (IL-1ß) and for estimating lymphocyte proliferation index (LPI). RESULTS: The upregulated IL-1ß and TNF-α around calving might be possibly associated to the metabolic changes occurring during the transition period and suggest a higher degree of inflammation around parturition. High concentrations of BHBA caused increased expression and synthesis of the pro-inflammatory factors such as TNF-α and IL-1ß in supplemented group in primary calf hepatocytes. The LPI was higher in supplemented group as compared to control which suggests a stimulatory effect of unsaturated fatty acids on mitogen-stimulated T-cell proliferation. CONCLUSION: Dietary supplementation of probiotics, prilled fat, and sweetener alleviated negative energy balance by stimulating feed intake and modulating hepatic lipid metabolism; and both of these additives improved the postpartum health (antioxidant status and immune function) of transition dairy cows.

A curious case of foreign body induced jejunal obstruction and perforation.

INTRODUCTION: Accidental and unnoticed ingestion of foreign bodies are not very uncommon. Most of such foreign bodies pass through gastrointestinal tract uneventfully and only on rare instances cause obstruction and/or perforation. PRESENTATION OF CASE: We are reporting a case in which a 45 yr old male presented to accident and emergency department of our institute with complaints of pain abdomen, greenish vomiting, abdominal distension, fever and non passage of flatus and stool following alcoholic binge 15 days back. On presentation tachycardia, hypotension, generalised abdominal tenderness and guarding were present. After initial resuscitation and investigation diagnosis of perforation peritonitis was made and emergency exploratory lapratomy was done and a single perforation with plastic foreign body protruding through it was found in jejunum 5cm distal to duodeno-jejunal junction. DISCUSSION: The majority of ingested FBs that reach the stomach pass uneventfully through the gastrointestinal tract. The majority of cases occur in children. Only 1% of patient of patients requires surgical intervention depending upon nature, size and shape of the foreign body. CONCLUSION: Present case report intends to draw the attention towards possibility of intestinal obstruction and perforation by a single plastic foreign body. High index of suspicion is needed as this foreign body is not even radio-opaque and cannot be picked up in X-ray investigations. Also with increasing use of such plastic materials there are increased chances of such incidents.

Primary mucoepidermoid tumor of the middle ear and mastoid.

Mucoepidermoid tumors are salivary gland neoplasms located mainly in the parotid gland. We present an unusual case of such a tumor arising from the middle ear and mastoid cavity successfully treated by surgery and post-operative radiotherapy.